摘要
目的:探讨甲泼尼龙治疗重症社区获得性肺炎(severe community acquired pneumonia,SCAP)的疗效及其对血清炎症因子水平的影响。方法:将2014年2月至2018年2月北京朝阳急诊抢救中心收治的80例SC A P患者随机分为2组,对照组(40例)采用抗感染等基础治疗,观察组(40例)在对照组基础上增加甲泼尼龙治疗,均治疗1周。观察两组疗效、临床症状消失时间以及治疗前后血气指标和炎症因子的变化。结果:观察组治疗有效率高于对照组(90.00%vs 70.00%,P<0.05);观察组发热[(2.01±0.19)dvs(3.14±0.25)d],喘息[(3.26±0.39)dvs(5.24±0.69)d],咳嗽咳痰[(5.13±0.92)dvs(6.35±0.25)d],肺湿啰音[(3.76±0.52)dvs(5.37±0.63)d]持续时间短于对照组,差异有统计学意义(P<0.05)。两组治疗后动脉血氧饱和度(ar terialox ygensaturation,O_2sat)、动脉血氧分压((ar terial blood carbondiox idepartial pressure,PO_2)、动脉血p H值增高;动脉血二氧化碳分压(arterial blood carbon dioxide partial pressure,PCO_2)、血清肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白介素-8(interleukin-8,IL-8)、超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)水平降低,差异有统计学意义(P<0.05)。观察组治疗后PCO_2[(43.15±4.33)mm Hgvs(47.08±5.12)mm Hg],TNF-α[(2.26±0.35)ng/m Lvs(3.69±1.25)ng/m L],IL-8[(2.31±0.65)vs(4.32±1.76)ng/m L],hs-CRP[(7.35±2.26)mg/L v s(14.15±5.32)mg/L]低于对照组,差异有统计学意义(P<0.05)。观察组O_2sat[(89.25±6.35)%v s(80.24±5.39)%],PO_2[(65.34±7.95)mm Hgvs(54.23±6.07)mm Hg],pH[(7.49±0.65)vs(7.31±0.52)]高于对照组,差异有统计学意义(P<0.05)。结论:甲泼尼龙可提高SCAP疗效,并有效降低血清炎症因子水平。
Objective:To investigate the therapeutic effect of methylprednisolone on severe community acquired pneumonia(SCAP)and its effect on serum inflammatory factors.Methods:Eighty patients with SCAP admitted to Beijing Chaoyang Emergency Rescue Center from February 2014 to February 2018 were randomly divided into 2 groups.The control group(40 cases)received basic treatment such as anti-infection.The observation group(40 cases)received methylprednisolone on the basis of basic treatment.All patients were treated for 1 week.The therapeutic effect,time of clinical symptom disappearance,changes of blood gas index and inflammatory factors before and after the treatment were observed.Results:The effective rate of the observation group was higher than that of the control group(90.00%vs 70.00%,P<0.05);fever[(2.01±0.19)d vs(3.14±0.25)d],wheezing[(3.26±0.39)d vs(5.24±0.69)d],lung moist rales[(3.76±0.52)d vs(5.37±0.63)d],duration of cough and expectoration[(5.13±0.92)d vs(6.35±0.25)d]in the observation group were shorter than those in the control group.The differences were statistically significant(P<0.05).After the treatment,arterial oxygen saturation(O2sat),arterial oxygen partial pressure(PO2),arterial pH increased;arterial carbon dioxide partial pressure(PCO2)and levels of serum tumor necrosis factor-α(TNF-α),interleukin-8(IL-8),and high-sensitivity C-reactive protein(hs-CRP)decreased.The differences were statistically significant(P<0.05).After the treatment,PCO2[(43.15±4.33)mmHg vs(47.08±5.12)mmHg]and levels of serum TNF-α[(2.26±0.35)ng/mL vs(3.69±1.25)ng/mL],IL-8[(2.31±0.65)ng/mL vs(4.32±1.76)ng/mL]and Hs-CRP[(7.35±2.26)mg/L vs(14.15±5.32)mg/L]in the observation group were lower than those of the control group.The differences were statistically significant(P<0.05).O2sat[(89.25±6.35)%vs(80.24±5.39)%],PO2[(65.34±7.95)mmHg vs(54.23±6.07)mmHg]and pH[(7.49±0.65)vs(7.31±0.52)]of the observation group was higher than those of the control group.The differences were statistically significant(P<0.05).Conclusio
作者
申芳芳
王廷海
李可欣
王龙
钱雪梅
SHEN Fangfang;WANG Tinghai;LI Kexin;WANG long;QIAN Xuemei(Beijing Chaoyang Emergency Rescue Center,Beijing 100122,China)
出处
《临床与病理杂志》
2020年第7期1728-1733,共6页
Journal of Clinical and Pathological Research
基金
北京市科学技术委员会科研计划项目(D151100004123009)。
关键词
甲泼尼龙
重症社区获得性肺炎
炎症因子
肺炎
社区获得性肺炎
methylprednisolone
severe community acquired pneumonia
inflammatory factors
pneumonia
community acquired pneumonia
inflammatory factors
